Andhra Pradesh

East Godwari-II at Rajahmundry

CC/49/2015

Smt. Koduri Vijaya Durga - Complainant(s)

Versus

M/s. National Insurance Company Ltd., Rep. by its Senior Branch Manager, - Opp.Party(s)

K. Badrinath

11 Dec 2015

ORDER

                                                                                       Date of filing:   20.08.2015

                                                                                                Date of Order: 11.12.2015

 

BEFORE THE DISTRICT CONSUMER FORUM-II, EAST GODAVARI

DISTRICT AT RAJAHMUNDRY

 

          PRESENT:   Sri A. Madhusudana Rao, M.Com., B.L.,  .. President (FAC)

                    Sri S.Bhaskar Rao, M.A., B.L., D.P.M.,    .. Member

                               

             Friday, the 11^th day of December, 2015

 

C.C.No.49 /2015

Between:-

 

Smt. Koduri Vijaya Durga, W/o. Someswara Rao,

Aged 60 years, Housewife, D.No.6-46, Near Kalyana

Mandapam, Ainavilli Lanka, Ainavilli Mandal, E.G. Dt.                                                     …  Complainant

 

                                    And

 

1)  M/s. National Insurance Company Ltd.,

     Represented by its Senior Branch Manager,

     D.No.29-10-10, 1^st Floor, Vijaya Complex,

     Opp. Gowtami Grandhalayam, Rajahmundry,

     E.G. Dt.

 

2)  M/s. National Insurance Company Ltd.,

     Represented by its Branch Manager,

     D.No.7-1-100/1, Opp. Victory Bazaar,

     Near Sreedevi Market, Amalapuram, E.G. Dt.,

     533201.                                                                                                                    …  Opposite parties

 

 

            This case coming on 03.12.2015 for final hearing before this Forum in the presence of Sri K. Badrinath, Advocate for the complainant and Sri R.A. Mohan, Advocate for the  1^st & 2^nd opposite parties, and having stood over till this date for consideration, this Forum has pronounced the following:  

 

O R D E R

[Per Sri A. Madhusudana Rao, Member] 

This is a complaint filed by the complainant U/Sec.12 of Consumer Protection Act 1986 to direct the opposite parties 1 and 2 to pay an amount of Rs.1,00,000/- towards insurance policy amount on Cattle shed and award subsequent interest at 24% p.a. from the date of claim till the date of realization; to pay damages, loss of damages to the furniture, bricks, woods etc. in the cattle shed as per policy at Rs.50,000/- and expenditure for obtaining the Meteorology Report at Rs.5,000/-; to pay Rs.1,00,000/- towards loss of mental agony for deficiency of services caused to the complainant in payment of insurance amount and award Rs.3,000/- towards costs and expenses of the complaint.

2.         The case of the complainant is as follows:-  It is submitted that the complainant own a Tiled Cattle Shed in D.No.6-46 in Ainavilli Lanka village, which is constructed in the year 1992 and the same is insured with the opposite parties 1 and 2 company under Policy No.560401/11/13/3165000012 for an amount of Rs.1,00,000/-.  The policy covered risk for the R.C.C. building, cattle shed tiled house building, compound wall, stocks and contents.  The policy is renewed periodically at the request of agents of the opposite parties 1 and 2 and they come and used to collect the premium and the validity period is till 21.4.2016.  The complainant submits that on 22.11.2013 due to the high raised winds and huge cyclone effect caused due to Helen Cyclone, the cattle shed is completely damaged and the same is intimated to the opposite parties 1 and 2 immediately. The company officials rushed to the premises and took photographs and took signatures of the complainant on some forms and papers, intimated that the claim will be settled in a short period.  Subsequently, the 1^st opposite party asked the complainant to attend Rajahmundry office, and demanded to produce a certificate from the Tahsildar, Ainavalli Mandal regarding the said calamity and complainant submitted the said M.R.O. Certificate Ref. No.194/2013 dt.30.11.2013.  But the opposite parties did not settle the claim so far. Subsequently, the complainant made several oral and written representations dt.25.1.2013 and 20.2.2015 to settle the claim. The opposite party demanded the complainant to get a report from the Meteorology Department, Visakhapatnam about the status of Helen Cyclone, which is out of the complainant’s purview.  But at the opposite party demand, the complainant by spending an amount of Rs.5,000/- obtained the said report dt.13.2.2015 and submitted to the opposite party department. The language of the said report is not known to common public, but the 1^st opposite party simply came to an understanding finally and rejected the complainant’s claim on 12.3.2015, without any base or reason, and reported that file is closed as No Claim. The complainant got issued regd. legal notice dt.24.3.2015 to the 1^st opposite party and the          1^st opposite party gave a litigious reply to the complainant and did not settle the insurance claim.  Hence, the complaint.

3.         The 1^st opposite party filed its written version and the same was adopted by the  2^nd opposite party and denied all the allegations made by the complainant. This opposite party submits that it had issued a policy in the name and style of Standard Fire and Special Perils Policy in favour of the complainant for a period of 3 years on 22.4.2013 covering RCC building, tiled house, cattle shed and compound wall.  It is submitted that on 25.11.2013, the complainant intimated the alleged loss or damage to this opposite party. Immediately, on receipt of the same, this opposite party appointed one of the panel surveyors by name Sri V. Satya Sai Baba of Rajahmundry for conducting survey on 26.11.2013. Then immediately, the said surveyor conducted survey in the presence of complainant’s husband Sri Someswara Rao and took photographs etc. and asked the complainant to furnish the required certificates etc. and explained everything of the survey. Thus, the complainant’s husband who is acting on behalf of his wife, the complainant herein accepted the said survey. But the complainant did not furnish the required documents immediately and therefore on receipt of those documents on 18.9.2014, the surveyor gave report to this opposite party on 23.10.2014. The survey was made impartially and the report is accepted by the opposite parties and thus it is unchallengeable. This opposite party submits that the surveyor after keen observation of the premises, gave detailed findings in his report in column CONCLUSION by holding that the cattle shed was not damaged due to “HELEN” cyclone and arrived net recommended loss as “NIL”. The said survey was made in strict adherence of rules and guidelines to be followed in conducting survey. The said findings were told to the complainant’s husband who accepted orally. It is further submitted that the surveyor along with his report furnished the photographs taken during the survey which clinchingly prove that there was no damage was caused due to the alleged HELEN cyclone, but for 20 years above old construction and substandard quality of timber and wood and natural depreciation. It is submitted that on 18.2.2015, the complainant submitted the claim form duly signed and her husband signed as witness.  This opposite party lastly submits that as the surveyor assessed the estimated net loss as Nil basing on the same, this opposite party repudiated the claim and intimated to the complainant under acknowledgement. Thus, the repudiation of the claim made by the opposite party is perfectly valid under law.  Therefore, there is no deficiency of service on the part of the opposite parties and the complaint is liable to be dismissed with costs.

4.         The proof affidavit filed by the complainant and Exs.A1 to A12 have been marked. The opposite parties filed proof affidavit and Exs.B1 to B5 have been marked.

5.         Heard both sides.

6.         Points raised for consideration are:

 

1. Whether there is any deficiency in service on the part of the opposite parties?

          2. Whether the complainant is entitled for the reliefs asked for?

          3. To what relief?

         

7.  POINT Nos.1 & 2:  We observed from the available record that the complainant herein obtained Standard Fire and Special Perils Policy vide Policy No.560401/11/13/3165000012 from the opposite parties under Ex.A1 = Ex.B1. The policy issued by the opposite parties insurance company is valid from 22.4.2013 to 21.4.2016 (three years). The policy covered the risk of RCC building costing about Rs.2,00,000/-, tiled house costing Rs.2,00,000/-, tiled cattle shed costing Rs.1,00,000/-, compound wall costing Rs.1,00,000/- and furniture, fixtures and fittings costs about Rs.1,00,000/-. The total insurance obtained by the complainant for her property contained in Door No.6-46 at Ainavilli Lanka of Ainavilli Mandal is Rs.7,00,000/-.

We further observed that due to Helen cyclone on 22.11.2013, the insured tiled cattle shed of the complainant was damaged badly and loss occurred to the complainant and the same was informed in writing to the opposite parties on 25.11.2013 as per Ex.A2. After receipt of this information, the opposite parties deputed an insurance surveyor by name V. Satya Saibaba to assess the loss occurred to the complaiannt and that surveyor filed his report vide Ex.B2 dt.23.10.2014 along with Ex.B3 photos. Further, the office of the Thasildar of Ainavilli Mandal certified the loss caused to the complainant’s cattle shed roof top damage due to Helen cyclone vide Ref.B/194/2013 dt.30.11.2013 under Ex.A4. Ex.B5 is the fire and special perils claim form submitted on 18.2.2015 by the complainant towards claim settlement. Ex.B4 is the letter addressed by the complainant to the 1^st opposite party insurance company stating that she sent the M.R.O. Certificate to their office and further stated that she could not inform the same to them immediately as she is residing at Delhi with her son. Ex.A12 newspaper report also supported the contention of damage due to Helen cyclone during 21.11.2013 and 22.11.2013 in the Konaseema region of East Godavari District. It is further observed that as per the requirement of the opposite parties insurance company, the complainant obtained Ex.A5 cyclone report from the India Meteorological Department, Visakhapatnam center. Ex.A3 is the letter addressed to the 1^st opposite party by the complainant stating that she incurred an amount of Rs.2,073/- towards fees for the cyclone certificate and Rs.1,500/- towards travelling expenses.

            After submission of claim form and all the necessary certificates for the settlement of claim, the opposite parties informed the complainant on 12.3.2015 that her claim file was closed as no claim under Ex.A6 letter.  On that, the complainant got issued legal notice dt.24.3.2015 to the 1^st opposite party under Ex.A7 and sent under Ex.A8 receipt and Ex.A9 acknowledgement card. Ex.A10 is the reply notice issued by the opposite parties legal counsel. Ex.A11 is the house tax receipt for the Door No.6-46 of the complainant.

           It is observed that the effect of Helen cyclone is continued for about two days in the coastal region of Andhra Pradesh and because of that cyclone, heavy damage occurred in the 14 coastal mandals in East Godavari of Andhra Pradesh. Agricultural crops, electrical poles and several houses were damaged due to fall of trees due to heavy rain and gale, particularly in I. Polavaram Mandal nearly 10000 acres agricultural crops, 80 electrical poles and 120 houses were damaged, which can explain the severity of Helen cyclone as per the news items published and the loss certificate issued by the Mandal Revenue Officer.  Further, the India Meteorological Department Cyclone Warning Center, Visakhapatnam issued for the date of 22.11.2013 clearly stated about strong winds along coastal districts and the wind speeds would increase up to gale wind speed of 100 to 110 kmph and further heavy rain fall warning over East and West Godavari Districts during the next 24 hours. So, all these reports including the survey report confirmed the loss was occurred due to Helen cyclone effect.

We further observed that the loss assessor in his report vide Ex.B2 enclosed Ex.B3 photos assessed the loss at Rs.1,11,944/- where as the complainant estimated the loss occurred to him was at Rs.1,20,000/- whereas the policy was obtained by the complainant towards tiled cattle shed was only at Rs.1,00,000/-. The details of loss assessment by the surveyor is mentioned below: 

Assessed amount of loss                     =          Rs. 1,11,944-00

Less depreciation @ 80%                   =                   89,555-00

Net assessed amount                           =                  22,389-00 

 

FINAL ADJUSTMENT OF LOSS AS PER POLICY CONDITIONS

 

Assessed amount of loss                     =                   22,389-00

Less Salvage                                       =                 12,389-00

                                                                           

                                                                            10,000-00

Less policy excess                               =                 10,000-00

                                                                           

Net Assessed loss                                                      NIL

Net recommended amount                 =                      NIL

We are in the opinion that the above assessed loss is nothing but arbitrary, illegal and one-sided.  It is a known fact that all the insurance policies will be issued by the insurer after assessing the value of the properties on the date of proposal only. But, after loss incurred there is no meaning in further depreciating the value of insured property once loss is occurred. In the present case, loss was occurred only after six months of obtaining policy though the policy was issued for a period of 3 years. Further, it is observed that as per the terms and conditions of Standard Fire and Special Perils Policy vide Ex.B1, the insurer was only entitled to deduct only 5% of claim subject to minimum of Rs.10,000/- for each and every loss arising out of act of god perils under general exclusions. The loss occurred due to Helen cyclone is nothing but act of god peril and all the reports confirmed that loss was occurred in that region including the village of the complainant. The photographs filed by the opposite parties clearly showed that the loss was occurred to the tiled roof top of the insured cattle shed and the wooden structure failed and the wooden roof compressed at failed support wooden structure though the cattle shed was not collapsed completely and so, loss was occurred to the complainant. Though the loss was assessed as Rs.1,11,944/- by the surveyor, the loss can be restricted only to Rs.1,00,000/- as per the coverage for the tiled cattle shed under the policy obtained by the complainant.

With the above said discussion under the facts and circumstances of the case, we are in the considered opinion that the opposite parties insurance company is entitled to deduct only Rs.10,000/- under the policy excess clause plus salvage only and the insurance company is not entitled to deduct depreciation on the insured asset. The salvage was estimated at Rs.12,389/- by the loss assessor can be deducted from the insurance amount along with Rs.10,000/- as policy excess. So, the insurance company can deduct only Rs.22,389/- out of Rs.1,00,000/- insured amount. The balance amount is Rs.77,611/- is payable to the complainant as insurance claim towards loss occurred to the insured tiled cattle shed of the complainant along with interest and costs of this complaint.                                        

 

8.   POINT No.3:  In the result, the complaint is allowed, directing the opposite parties 1 & 2 to pay an amount of Rs.77,611/- towards insurance claim with interest @ 9% p.a. from the date of demand i.e. 24.03.2015 till realization to the complainant. We further direct the opposite parties 1 & 2 to pay Rs.1,000/- towards costs to the complainant. Time for compliance is two months from the date of this order.   

 

Typed to dictation, corrected and pronounced by us in open Forum, on this the           

11^th day of December, 2015.

    

                Sd/-xxx                                                                                     Sd/-xxx

              MEMBER                                                                              PRESIDENT(FAC)

         

 

APPENDIX OF EVIDENCE

WITNESSES EXAMINED

 

FOR COMPLAINANT: None.                                                               FOR OPPOSITE PARTIES: None.

 

DOCUMENTS MARKED

FOR COMPLAINANT:

 

Ex.A1    dt/22.4.2013    Policy issued in the name of the complainant.

Ex.A2    dt/25.1.2013    Letter addressed to the opposite parties by the complainant.

Ex.A3    dt/20.2.2015    Letter addressed to the opposite parties by the complainant.

Ex.A4    dt/30.11.2013  Certificate issued by the Tahsildar, Ainavalli Lanka.

Ex.A5    dt/13.2.2015    Report of the Meteorology Department, Visakhapatnam.

Ex.A6    dt/12.3.2015    Letter of repudiation of the claim by the 1^st opposite party.

Ex.A7    dt/24.3.2015    O/c of Regd. notice issued to the 1^st opposite party.

Ex.A8    dt/24.3.2015    Postal receipt.

Ex.A9    dt/29.3.2015    Acknowledgement from the 1^st opposite party.

Ex.A10  dt/30.3.2015   Reply issued by the counsel of the 1^st opposite party.

Ex.A11                       Tax paid to the Cattle shed by the complainant.

Ex.A12  dt/23.11.2013  News paper clipping showing the disaster in Helen Cyclone.

 

 

FOR OPPOSITE PARTIES:-  

 

Ex.B1    Attested copy of policy bearing No.560401/11/13/3165000012 with printed

            conditions.

Ex.B2    Original survey report dt.23.10.2014 of Sri V. Satya Saibaba Insurance Surveyor,

             Rajahmundry.

Ex.B3    Photographs (9 in no’s).

Ex.B4    Letter dt.6.2.2015 addressed by the complainant to the 1^st opposite party.

Ex.B5    Fire and Special perils claim form dt.18.2.2015 duly signed by the complainant and

             her husband as witness.

                 Sd/-xxx                                                                                         Sd/-xxx

              MEMBER                                                                              PRESIDENT(FAC)